Writing about emotional experiences to improve lung function and quality of life in patients with asthma: 3-month follow up of a randomised controlled trial

Jones, C.J., Theadom, A., Smith, Helen, Hankins, M., Bowskill, R., Horne, R. and Frew, A.J. (2008) Writing about emotional experiences to improve lung function and quality of life in patients with asthma: 3-month follow up of a randomised controlled trial. Thorax, 63, supplement 7, A18-A21.

Abstract

Introduction: Stress has been associated with the exacerbation of asthma symptoms. Written emotional disclosure encourages people to write about their most stressful experiences facilitating cognitive and emotional processing. When conducted partly in a research laboratory, written emotional disclosure was found to yield a 12\% increase in FEV1 percentage predicted in people with asthma. Given the link between stress and asthma, this trial was aimed at exploring the effectiveness of a 3-day written emotional disclosure intervention on lung function and quality of life for adults with asthma in a community setting. Methods: A randomised controlled trial was carried out on 138 adults with asthma aged between 18 and 45 years who were recruited through 32 general practices. Participants were randomly allocated to receive the emotional disclosure or the non-emotional control writing instructions. Participants completed the writing in their own home without researcher supervision for 20 minutes over three consecutive days. Assessments of lung function (FEV1 \% predicted) using spirometry and questionnaires measuring quality of life, asthma symptoms, subjective asthma control and medication use were conducted at baseline, 1 and 3-month follow-up (see fig). Results: Baseline analysis showed a significantly higher proportion of smokers in the control condition but no differences in lung function. Controlling for smoking status, no significant findings for lung function, quality of life or asthma symptoms were found. At 3-month follow-up, participants in the intervention condition reported significantly better subjective control of their asthma (as defined by the asthma control test): odds ratio (OR) 3.01, 95\% CL 1.30 to 6.94 and reported significantly better objective control of their asthma (defined as using their b-agonist less than once a day): OR 2.96, 95\% CL 1.38 to 6.33 (see fig). Conclusions: Participants receiving the emotional disclosure intervention were more likely to demonstrate good control of their asthma both by self-report and a reduction in use of b-agonist. Although there was no effect of written emotional disclosure on lung function, this could be due to the observed reduction in bagonist use. These reductions are in line with the National Heart, Lung and Blood Institute guidelines, which state that effective management of asthma should involve a reduction in b-agonist use

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